Abstract
This review reports the experience of nine studies in Chinese maternity hospitals with insertions of an intrauterine device (IUD) at the time of cesarean section. In contrast to the usually high expulsion rates associated with immediate postpartum vaginal insertions, all nine studies reported low expulsion rates, thus resulting in high continuation rates with this procedure, comparable to those with interval insertions. This immediate post-cesarean section insertion procedure was also found to be safe.
These findings are of programmatic importance for postpartum family planning delivery services and may eventually lead to an understanding of the expulsion mechanism in postpartum IUD contraception. Results of these reports have been synthesized in this review. Seven of these nine reports were originally in Chinese and were translated into English for the benefit of a broad international audience. Future research directions on this insertion procedure are also discussed.
Resumé
Cette analyse porte sur neuf études faites dans des maternités chinoises sur des insertions de dispositifs intra-utérins (DIU) lors d'une césarienne. Alors que les taux d'expulsion sont généralement élevés lors d'insertions vaginales post-partum immédiates, ces neuf études ont toutes montré des taux d'expulsions faibles, comparables à ceux des insertions après intervalle. On a également constaté qu'une insertion pratiquée immédiatement après une césarienne est une méthode sûre.
Ces résultats sont très importants pour le planning familial d'une famille après une naissance et peuvent, par la suite, permettre de comprendre les mécanismes d'expulsion en cas de contraception post-partum avec stérilet. Ce document synthétise les résultats de ces études. Sept rapports ont été initialement rédigés en chinois et traduits en anglais pour des lecteurs de tous pays. La discussion porte également sur les voies d'investigation future quant à cette méthode d'insertion.
Sumario
Esta revisión relata la experiencia de nueve estudios en hospitales de maternidad chinos, con inserciones de un dispositivo intrauterino (DIU) en el momento de una operación cesárea. Contrastando con las habituales altas tasas de expulsión asociadas con inserciones vaginales inmediatas postparto, los nueve estudios informan bajas tasas de expulsión resultando así en altas tasas de continuidad con este procedimiento, comparables a aquéllas con inserciones de intervalo. Esta inserción inmediata a la operación cesárea se encontró es segura.
Estos hallazgos son de importancia programática para los servicios de planificación familiar postparto y, eventualmente, pueden conducir a la comprensión del mecanismo de expulsión en la anticoncepción postparto con DIU. Los resultados de estos informes han sido resumidos en esta revisión. Siete de estos nueve informes estaban originalmente en chino y fueron traducidos al inglés para el beneficio de una amplia audiencia internacional. También se discuten posibles direcciones de futuras investigaciones de este procedimiento de inserción.
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Chi, IC., Ji, G., Siemens, A.J. et al. IUD insertion at cesarean section — the Chinese experience. Adv Contracept 2, 145–153 (1986). https://doi.org/10.1007/BF01849224
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DOI: https://doi.org/10.1007/BF01849224